Doctor Name: | MRS. CAROLYN F. VARGAS-JACKSON |
NPI Number: | 1295112654 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC/SLP |
License Number: | 2202005711 |
Business Practice Address: | 506 Green Town Rd Farmville, VA - 239013093 |
Business Phone Number: | 7742189438 |
Business Fax Number: | |
Mailing Address: | Po Box 52, FARMVILLE |
State: | VA |
Postal Code: | 239010052 |
Phone Number: | 7742189438 |
Fax Number: | |
NPI Enumeration Date: | 05/05/2015 |
NPI Last Update Date: | 05/05/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2202005711 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |